N.S. plans health spending, balanced budget with aid of higher federal transfers

Nova Scotia’s Liberal government took steps to renew its struggling health care system in a balanced budget Tuesday, though critics say the efforts are incomplete and poorly targeted.

Finance Minister Karen Casey introduced her government’s fourth consecutive balanced budget, projecting a thin $33.6-million surplus for 2019-20, on planned spending of about $11 billion.

There are no increases in taxes or fees, but more than $178 million in additional funds from Ottawa are helping cover the costs.

Spending increases by Premier Stephen McNeil’s government are sprinkled in small increments including more funding targeted at homecare, new tax credits to assist new firms, and new public awareness programs that will begin as the sales of edible marijuana products start up.

However, the Liberals biggest spending increase by far is in the health budget.

The government confirmed $157 million in capital grants for “the largest health care redevelopment projects in Nova Scotia history,” at the Queen Elizabeth II Health Centre in Halifax and the Cape Breton Regional Health Centre in Sydney.

The budget notes that 120 long-term care beds will eventually be added as part of the Cape Breton project, as well as beds that are part of replacement projects in Meteghan and Mahone Bay, but these additions won’t be coming this year.

In addition, the budget for the Nova Scotia Health Authority – the province’s merged health agency – is up $57.2 million.

Overall, when compared to last year’s budget estimate, spending on health would grow by more than $191 million over the amount spent in 2018-19.

Casey devoted close to a quarter of her speech to the province’s health care system, which has come under continuing criticism for hospital crowding, doctor shortages and high numbers of pressure injuries among nursing home residents.

“When we looked at what the needs were and what the province could afford we were certainly identifying health as a priority,” she told reporters just before speaking in the legislature.

The province’s health spending has grown by almost one fifth in five years to $4.6 billion, consuming a steadily rising percentage of the government’s revenues.

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However, a portion of this year’s projected increase is the result of health transfer and equalization payments from the federal government, which make up about one-third of all Nova Scotia’s revenues.

This included an agreement that provided an additional $28.5 million for mental health care.

The province is also planning $16.8-million for home care, and another $10-million for collaborative care centres to help battle the persistent shortage of family doctors.

The province’s opposition parties criticized McNeil’s government for failing to spend enough on what they said are some of the root causes of the province’s health care problems.

“The government can spend more money but the delivery of health care is not improving,” said Tory Leader Tim Houston.

“Health care in this province is getting worse and worse.”

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Meanwhile, NDP Leader Gary Burrill said hospitals will continue to be too crowded, and as a result people will wait hours in emergency rooms.

He diagnoses the lack of nursing home care beds as among the key root causes, and noted there was little in the budget to address the shortfalls.

“It’s a dumpster full of disappointment … Every front line health care worker says the source of this is there’s an inadequate supply of long-term care beds to move people out of hospitals,” he said.

McNeil defended his government’s health spending, saying it will make a difference in service delivery.

The premier pointed to doctor-recruitment initiatives such as 15 new residency seats and a program that attaches foreign-trained doctors to family practices in order to help them get their Canadian credentials faster. He said the investments in health infrastructure will also make a difference.

“People are recognizing that in order to recruit and retain health care providers we need new and modern infrastructure and this budget reflects that.”

McNeil was asked about a charge from the Nova Scotia Government and General Employees Union, which accused the government of “tunnel vision” in balancing the budget at the expense of health care.

“I would say to them sustainability matters,” McNeil said. “Being able to afford the health care that Nova Scotians deserve is important and at the same time we have to be able to grow the economy.”

Meanwhile, the province is bringing in some minor tax changes aimed at encouraging investment in businesses.

The budget calls for $3 million to pay for a new venture capital tax credit aimed at encouraging equity investments in Nova Scotia companies.

In addition, it is setting up tax credits that are effective on April 1 that will give a tax break to startup firms that have existed for less than 10 years.

The net debt is estimated to be $15.3 billion, about $15,858 per person, but has fallen slightly as a percentage of gross domestic product.

Education funding is up by about $33 million, though much of the funding is continuing money for already announced programs.

That includes $10.2 million of already announced money to continue rolling out a pre-primary program for four years at schools around the province.

“By September 2020, we anticipate that every four-year-old in Nova Scotia will have access to a free, pre-primary, early learning opportunity,” said Casey.

The minister also noted the funding for cannabis legalization related to the introduction of edibles and concentrates is going up by $1.1 million for a budget of $3.5 million.

Those funds will go to public awareness campaigns, staffing and more screening equipment for policing agencies.